Women may now be able to stop that biological clock from
ticking, thanks to a breakthrough technique that removes a piece of a woman's
ovary, to be grafted on later when she wants to have children.
For many women, the ticking of your biological clock can
be incredibly stressful. But here's some good news: An international team of
researchers presenting at the European Society for Human Reproduction and
Embryology in Istanbul this week have pioneered a technique that puts menopause
on hold indefinitely, allowing women to put off having children till much later
in life. Here, a concise guide to the groundbreaking procedure:
Why would women
want to delay menopause?
If your period marks the official start of "your
usefulness as a baby vessel," consider menopause "the long, slow
death wail of your fertility," says Cassie Murdoch at Jezebel. But "a
woman born today has a 50 percent chance of living to 100." says Dr.
Sherman Silber, who has performed the new procedure on 11 women in St. Louis.
"That means they are going to be spending half of their lives
post-menopause." But now, this procedure gives a woman more time to focus
on her career, become financially stable, and perhaps most importantly, allows
her to start a family when she chooses to.
How does the new
technique was developed?
Dr. Jehoshua Dor, a professor of obstetrics and
gynecology at the Sackler School of Medicine in Tel Aviv University, Israel and
an internationally respected researcher, long ago theorized on how a woman can
freeze a piece of her ovary while she is young and have it replaced in
perimenopause to avoid going through menopause and never need to take hormones.
But recently, he has actually developed a ground-breaking method to restore
fertility in patients who went through menopause due to chemotherapy. These
women were in their 30s and 40s and wanted to have children in the future. To
preserve their fertility, Dr. Dor performed a laparoscopy and took a small
piece of tissue from the ovary and cut it into strips and froze those strips so
that it could be replaced back into the woman's ovary via laparoscopy after she
recovered from her disease.
Following replacement of the ovarian tissue, the women's
menopause reversed and they began to menstruate and develop functional ovaries
that could produce both eggs and estrogen. The first women to deliver a baby
with the help of in vitro fertilization by using her own ovarian tissue after
being in menopause was published in the New England Journal of Medicine.
Dor and his team realized that several years after the
operation, the women were still producing hormones. In some cases they also
were able to become pregnant again even without the help of in vitro
fertilization. To date, 30 babies have been born by this method and half
conceived on their own without fertility treatment. No other hormones were
necessary.
How much time does
the procedure buy?
Theoretically, a woman could have kids well into old age,
as long as she is physically able to carry a baby to term. "You could have
grafts removed as young women, and then have the first replaced as you approach
menopausal age," says Dr. Silber. "You could then put a slice back
every decade." So far, transplants carried out eight years ago are still
working. "It's really fantastic," he says. "We didn't expect a
little piece of ovarian tissue to last this long."
Are there any side
effects?
Yes, both positive and negative. First, the good: Women
can avoid the "increased risk of osteoporosis and heart disease that come
with the end of their fertile life," says Stephen Adams. But there are
also downsides: The technique may raise a woman's risk of breast and womb
cancer due to having higher estrogen levels later in life.
When could the
technique be widely employed?
In a paper published 2012 in the journal Molecular Human
Reproduction, Dr Silber wrote: “All modern women are concerned about what is
commonly referred to as their ‘biological clock’ as they worry about the
chances of conceiving by the time they have established their career and/or
their marriage and their financial stability.
"Most of our cured cancer patients, who have young
ovarian tissue frozen, feel almost grateful they had cancer, because otherwise
they would share this same fear all modern, liberated women have about their
‘biological clock'."
The first operation, conducted on Oudara Touirat in
Belgium in 2003, led to a pregnancy and successful birth a year later. Strips
of her ovarian tissue were removed before chemotherapy for Hodgkin's lymphoma
and were replaced after she was given the all clear.
In 2008, The Daily Telegraph revealed that Susanne
Butscher, who received a whole ovary transplant in a world first from her twin
sister, had given birth to a daughter, named Maja. Mrs Butscher, then 39, had
gone through the menopause early. Dr Silber carried out the operation in 2007
and 13 months later it was confirmed she had conceived naturally.
All the women who have undergone the procedure have had
cancer but doctors said it was now time to extend it to others. Dr Gianluca
Gennarelli, a Turin-based gynecologist involved in the Italian case, said in
time it should be made available to women with other conditions - including
those likely to suffer early menopause due to family history.
He said: “In the 21st century many women don't want to
have children until they are in their 30s, rather than at 18. But if your
mother went through menopause before 40 that could be very difficult.”
Stuart Lavery, head of IVF at Hammersmith Hospital in
London, said the findings showed ovarian transplants could last a lot longer
than previously thought.
Previous studies had shown some only had “a very finite
lifespan” of six to nine months, meaning women having to have repeat
operations. Tim Hillard, a gynecologist and trustee of the British Menopause
Society, said the technique was 'exciting'.
He said: "This is an exciting developing as a
fertility treatment, however we would need much more data before claims could
be made about the menopause. You would have to balance it very carefully, the
higher risks of breast and womb cancer that go with having estrogen circulating
for longer against the increased risk of heart disease, osteoporosis and maybe
dementia that go with the menopause.
"Theoretically it could be used as an alternative to
hormone replacement therapy, particularly in women who go through the menopause
prematurely, but that could be ten or 15 years away."
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